Lawton Robert Burns and Gordon G. Liu (eds.) (2017).  China’s Healthcare System and Reform. Cambridge: Cambridge University Press. 458 pp., ISBN (hardback) 978-1-107-16459-8; ISBN (paperback) 978-1-316-61646-8.

Pia Eskelinen, University of Turku

Lawton Robert Burns and Gordon G. Liu’s edited book China’s Healthcare System and Reform aims to make sense of one of the biggest healthcare systems in the world. At first glance, the scope of the book’s theme appears alarmingly broad. However, the collection of expert essays constructs a comprehensive analysis of the development of the Chinese healthcare system and its reforms. All contributors are professionals in their own fields, and it is a breath of fresh air to collect their expertise into one comprehensive package.

China’s Healthcare System and Reform provides a complete review of China’s healthcare system and policy reforms in the context of the global economy. Previously, articles focusing on the Chinese healthcare system (e.g. Yip et al., 2012; Hougaard et al., 2011; Gong et al., 2012; Liu, 2004) have been published in various journals (e.g. The Lancet, Applied Health Economics and Health Policy, Bulletin of the World Health Organization). Thus, China’s Healthcare System and Reform is an essential manual for anyone interested in the Chinese healthcare system. Students, researchers, practitioners and policy-makers benefit from this thorough collection of essays.

There are several ways to analyse the healthcare system as is explained in the first chapter. It is extremely important to describe these methods as there are so many operators in the field of healthcare. The book’s 16 chapters cover the payers, the providers, and the producers (e.g. manufacturers) in China’s system. Expectations can be extremely high or unreal even, when a new colossal book is published. However, China’s Healthcare System and Reform meets all expectations. It provides a remarkable feat in collecting in one place the key elements of change and reforms on one of the most massive healthcare systems in the world.

The book provides a detailed analysis of the historical development of China’s healthcare system, the current state of its broad reforms, and the uneasy balance between China’s market-driven approach and governmental regulation. Most importantly, it devotes considerable attention to major problems confronting China, including chronic illness (non-communicable diseases), public health, long-term care and economic security for the elderly. In addition to that, two important themes emerge from the essays: the urgent need for reforms but also the concerns about rising costs in the healthcare system.

The book’s structure is very logical and easy to follow. Part one explains the analytic framework, history and how the public health system is connected to the infrastructure. Part two introduces healthcare reform in quite a detailed manner. This is followed by part three’s information on healthcare providers and part four’s overview and analysis on insurers and reimbursement. The final part, part five, introduces various kinds of product manufacturers.

One of the strengths of this book are the numerous charts, pictures and tables that are used throughout the book but especially in part five, “Product Manufacturers”. China’s Healthcare System and Reform is easy to use as a manual that provides adequate information on two key elements, evolution and reform. The use of many government sources (e.g. State Council, China Food and Drug Administration, National Health Insurance Administration) is also very interesting, because the Chinese curtain of secrecy can sometimes prevent researchers from acquiring information (see for example: chapter eight, “China’s Hospital Sector”; the eleventh chapter, “Health Insurance in China”; and the fourteenth chapter, “China’s Pharmaceutical Sector”). The book is very technical and at some points it would have been interesting to hear how the patients, actual users, of the healthcare system feel. However, the aim of the book is to introduce the healthcare organization and not to analyse how patients feel about the system.

In conclusion, this massive information package gives an extensive overview of the complexity of the Chinese healthcare system. It offers a comprehensive look at one of the world’s largest healthcare systems, its background and future. I truly hope this book inspires and encourages future researchers to take on the task to further study the Chinese healthcare system.

The editors, Burns and Liu, are experts in their field of study. This gives the book its professional feeling. Lawton Robert Burns is a James Joo-Jin Kim professor in the Health Care Management Department at the Wharton School. He is also the Co-director of the Roy and Diana Vagelos Program in Life Sciences and Management at the University of Pennsylvania. He has authored and co-authored many textbooks, scientific articles and publications.

Gordon G. Liu is a PKU Yangtze River Scholar Professor of Economics at the Peking University National School of Development, and director of the PKU China Center for Health Economic Research. In addition to that, he is a member of China’s State Council Health Reform Expert Advisory Committee. He has served as an associate editor for many academic journals.


Gong, Peng, Song Liang, Elizabeth J. Carlton, Qingwu Jiang, Jianyong Wu, Lei Wang and Justin V. Remais (2012), “Urbanisation and Health in China”, The Lancet 379(9818): 843–852.

Hougaard, Jens Leth, Lars Peter Østerdal and Yi Yu (2011), “The Chinese Healthcare System”, Applied Health Economics and Health Policy 9(1): 1–13.

Liu, Yuanli (2004), “China’s Public Health-Care System: Facing the Challenges”, Bulletin of the World Health Organization 82: 532–538.

Yip, Winnie Chi-Man, William C. Hsiao, Wen Chen, Shanlian Hu, Jin Ma and Alan Maynard (2012), “Early Appraisal of China’s Huge and Complex Health-Care Reforms”, The Lancet 379(9818): 833–842.